Provider Demographics
NPI:1437749751
Name:WILLIAMS, DANIEL (CAPSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:CAPSW
Other - Prefix:
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:N3152 STATE ROAD 81
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-8821
Mailing Address - Country:US
Mailing Address - Phone:608-328-9393
Mailing Address - Fax:608-328-9480
Practice Address - Street 1:N3152 STATE ROAD 81
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-8821
Practice Address - Country:US
Practice Address - Phone:608-328-9393
Practice Address - Fax:608-328-9480
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI130169-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker